Episode 173: Battling the Perimenopause Pounds

[00:00:00] Welcome back to the Back on Track Achieving Healthy Weight Loss, where I help you get on track and stay on track with your weight loss journey. I'm your host, Dr. Alicia Shelly. So let's get started.

[00:00:27] Welcome to the Back on Track Achieving Healthy Weight Loss podcast. I'm your host, Dr. Alicia Shelly.

[00:00:33] So today we are diving into a topic that affects so many women. In fact, it affects a majority of all of women, but it often goes unspoken. Menopause and weight gain. I've had several patients come to me and they sit in my office and they're like, doc, I've done nothing different. I have eaten the same. I exercise the same. And I'm still gaining weight. What is going on? And it is very stressful.

[00:01:03] It is stressful because when you're like, I've done nothing different and now I'm gaining weight. I need help. And if you have noticed any shifts in your body and you just can't seem to explain, or if it feels like your weight is changing, no matter what you do, know that you are not alone. And this could be due to perimenopause or perimenopause or menopause. The one thing that we can't choose is menopause. We're all opting into that if we live long enough.

[00:01:33] And so in today's episode, we're going to touch on not just menopause, but actually the transition called perimenopause as you transition into menopause. Now, perimenopause is a natural transition. Like I said, it's going from where you are just reproductive stage where now you're noticing perimenopause. And it's this transition right before your menopause.

[00:01:56] And it brings real changes in your hormones, metabolism, and even in our emotional health.

[00:02:03] And so today we plan to unpack the science behind why our bodies might be holding on to these extra pounds.

[00:02:10] And most importantly, how to approach this stage with realistic and empowering strategies for feeling strong, healthy, and confident.

[00:02:17] So let's get started and break down what perimenopause really means for our weight and well-being.

[00:02:23] And when we define perimenopause, it is defined as the time period prior to menopause.

[00:02:28] Menopause is defined as not having a menstrual cycle for 12 months.

[00:02:33] Now, usually in this perimenopause phase, it can occur either several years, months prior to actual menopause.

[00:02:41] And women tend to have changes in their cycles where they may notice that they are either longer or shorter than usual.

[00:02:49] Sometimes women will skip cycles.

[00:02:50] Like they feel their cycle's coming on, but they never have the bleeding.

[00:02:54] And for some women, this can happen for multiple months at a time.

[00:02:57] And then all of a sudden they get their cycle, which I've had people complain about that as well.

[00:03:02] And it's not uncommon for women to experience intermittent symptoms of menopause,

[00:03:07] meaning that they're experiencing hot flashes, mood swings, insomnia, or night sweats.

[00:03:13] Now, every woman is different.

[00:03:15] Every woman is a unicorn.

[00:03:17] And even if your mom had similar symptoms or different with the same thing,

[00:03:23] her symptoms and your symptoms may be different.

[00:03:25] And your sisters may be different.

[00:03:26] Your friends may be different.

[00:03:27] So every woman is different.

[00:03:29] We do have the average age range for perimenopause.

[00:03:32] Can start in their mid to late 30s and go into your early 50s.

[00:03:36] But the average age for perimenopause is around 47.

[00:03:41] And there are many factors that can lead to weight gain during this period.

[00:03:45] Now, we've spoken about different hormones in our earlier podcasts.

[00:03:49] But just to revisit, hormonally, you could see changes in your estrogen level,

[00:03:53] which can affect how the fat is stored in our body.

[00:03:57] Our fat, normally when we're in our reproductive phase,

[00:04:01] is stored in our hips or our leg area.

[00:04:03] But as our estrogen starts to decline, it starts to get stored in our abdomen.

[00:04:08] So a lot of my patients are like, I can't get rid of my stomach.

[00:04:12] My stomach is still here.

[00:04:13] And that's just natural.

[00:04:14] It's just due to the estrogen.

[00:04:15] We also see declining testosterone and progesterone levels as well,

[00:04:20] which can lead to more weight gain.

[00:04:22] Also during this time, we can see an increase in the ghrelin hormone,

[00:04:26] which is ghrelin is our hunger hormone,

[00:04:28] which tells us when we're hungry or stimulates us to say, hey, we're hungry.

[00:04:31] And so sometimes people may snack a little bit more,

[00:04:35] maybe hungrier, more than they realize from earlier age.

[00:04:38] Because this is more of a gradual progression.

[00:04:40] This doesn't happen all of a sudden.

[00:04:42] It's more of a gradual progression.

[00:04:44] There are also age-related factors.

[00:04:45] It just happens as we age, such as a decrease in our metabolism.

[00:04:50] As we age each and every year, our metabolism decreases.

[00:04:55] And it's just natural.

[00:04:56] So I have a lot of people where they're like, I remember when I was 20,

[00:05:00] when all I had to do was just stop eating pizza and I lost weight.

[00:05:04] Now I do the same thing and I'm not losing anything.

[00:05:08] And the reason being is that your metabolism is decreasing.

[00:05:13] And metabolism is how many calories your body needs to run.

[00:05:17] And so now what we're finding is that people are needing,

[00:05:21] the metabolism is slowing down by approximately 300 kilocalories per day.

[00:05:26] And so what we find, if somebody were to not do any lifestyle changes

[00:05:30] and just eat the same, move the same,

[00:05:32] just with them reducing their metabolism just each and every year,

[00:05:36] they can gain one to two pounds.

[00:05:38] And that can add up over 10, 20 years where you're like,

[00:05:42] all of a sudden, man, I'm 20 pounds heavier than I used to be.

[00:05:45] And a lot of it is just because of that age-related factors.

[00:05:48] Also, there's a decrease in energy expenditure.

[00:05:51] We're not needing as much energy.

[00:05:53] And then also there's a decrease in lean muscle mass as we age.

[00:05:58] And so the one thing you have to recall is that muscle definitely weighs more than fat,

[00:06:04] but it also burns more calories than fat does.

[00:06:06] So if you're losing lean muscle, what your body's able to burn decreases as well.

[00:06:12] And so also the other thing we have to mention too is the lifestyle factors that can increase our weight.

[00:06:19] When you're 20 and you don't have any responsibilities, you can go to the gym for two hours at a time.

[00:06:25] But as you age, you may have a family, you may have a spouse, you may have obligations.

[00:06:30] And so sometimes it's hard to schedule in the physical activity that you need.

[00:06:35] Sometimes it's hard to even meal prep so that you have proper meals already planned.

[00:06:40] You don't have to worry about it.

[00:06:42] So definitely the lifestyle changes make a difference.

[00:06:46] Our physical activity makes a difference.

[00:06:48] And then what if you are experiencing like more back pain, knee pain than you did when you were in your 20s?

[00:06:53] You have so funny.

[00:06:54] I love to run.

[00:06:56] Now, I remember I was running the Thanksgiving half marathon.

[00:06:58] I saw a young man in my church who was in his 20s and he's like,

[00:07:02] Oh, how'd your race go?

[00:07:03] I'm just waiting for my friend.

[00:07:05] He didn't practice.

[00:07:07] He didn't train for this 13 miles.

[00:07:10] He just took a pain pill and decided to run it.

[00:07:13] And I was thinking to myself, I was like, what?

[00:07:14] You just woke up and decided to run 13 miles?

[00:07:19] No wonder.

[00:07:20] He was like, no wonder why it's taking you so long.

[00:07:22] Because when you're young in your 20s, you're not feeling any, you know, you don't feel all the pain.

[00:07:28] I have to practice.

[00:07:29] I got to stretch before, stretch afterward.

[00:07:32] I have a knee brace.

[00:07:33] I have a whole regimen that I have to do prior to running because I'm old.

[00:07:39] My bones are creaking and we got to make sure we're in good shape.

[00:07:43] So it's funny the things we used to do as when we're in our 20s.

[00:07:47] And then now you look at him like, man, I can't believe I did that.

[00:07:50] So needless to say, our physical activity may be decreased because of some ailments that we're having.

[00:07:57] Also, other lifestyle factors that can affect your weight.

[00:08:00] Smoking affects your weight.

[00:08:02] Alcohol intake affects your weight.

[00:08:04] Sometimes, especially if we are drinking multiple glasses of alcohol per week, this is extra calories, which can lead to more weight gain.

[00:08:13] Now that we know the different factors that play a role with weight gain, what can we do about this?

[00:08:18] And how can we make, because we're all going to go, if we live long enough, we're all going to go through perimenopause and menopause.

[00:08:25] But how do we transition with grace?

[00:08:27] And the first thing I would say is, number one, give yourself grace.

[00:08:31] Because it is so frustrating to think about how you were able to lose weight in your 20s and be frustrated that you can't do it in your 40s, in your 50s.

[00:08:41] You're just like, I can't, you know, I just don't have the time.

[00:08:43] And so sometimes you have to give yourself grace and allow yourself time to find, you know, if you can't do that, what can you do?

[00:08:51] Ask yourself, what do I have time to do?

[00:08:53] I've got to take my kids to baseball practice or basketball.

[00:08:56] Well, while they're practicing, can I walk around the building?

[00:09:00] Can I walk?

[00:09:01] Do they have a place where I can walk around just so that I can get some steps in and some physical activity?

[00:09:06] I was telling a mom, she was in her 40s, she just had a baby, and she was just getting overwhelmed with everything.

[00:09:13] And I'm like, you know, she's like, I can't eat healthy.

[00:09:15] We just kind of eat what's available.

[00:09:17] You know, we have this baby, you know, a spouse.

[00:09:19] And I'm like, hey, maybe you should try delegating your meals.

[00:09:23] Like having somebody cook for you or getting a meal prep service where you just grab and go.

[00:09:28] You have meals for you and your spouse.

[00:09:31] Baby's still on breast milk, so it works out.

[00:09:33] But making sure that you have those healthy meals available.

[00:09:37] So make sure you delegate.

[00:09:38] And number one, give yourself grace.

[00:09:40] Secondly, delegate things.

[00:09:42] So you don't have to do everything.

[00:09:44] You don't have to be a superwoman.

[00:09:46] You know, you can delegate things to someone else that can help you.

[00:09:49] The other thing is a nutrition part.

[00:09:52] So, you know, taking an audit of how you're eating, asking yourself, is there areas where I can eat more healthy?

[00:09:58] Can I have more of a balanced meal?

[00:10:01] Something that has more fiber, making sure I'm getting my fruits and vegetables in, making sure I'm drinking water.

[00:10:07] You know, sometimes we don't realize this, but we get hooked on coffees.

[00:10:10] I'm from the South, so sweet tea, sodas, all these things.

[00:10:14] But we leave out water.

[00:10:16] We may only drink a bottle of water or a glass of water a day.

[00:10:20] And so making sure that we are getting the nutrients that we need for our body is going to be helpful.

[00:10:25] Because as we transition, especially to that perimenopause and menopause, we also start to lose calcium and vitamin D.

[00:10:32] So making sure that you're getting, which affects our bones, basically.

[00:10:36] And over years, it can lead to osteoporosis.

[00:10:39] So it's important that we're making sure that we're getting our nutrients in as well.

[00:10:43] Now, the one thing I will say is that as women hit that menopause, we are at increased risk for cardiovascular disease.

[00:10:51] And that's due to the estrogen protection because estrogen is leaving.

[00:10:55] It actually does have a little bit of protection cardiovascular.

[00:10:57] And so since that's decreasing, that protection is decreasing as well.

[00:11:01] Also, we're having more fat that's being stored in our abdomen area, which puts us at more risk for cardiovascular disease as well.

[00:11:09] So with that being said, I would recommend, and you talk to your doctor what is best for you because everybody has their own different ailments.

[00:11:17] And so some diets may be better than others.

[00:11:20] But making sure you're having more of a heart healthy diet, making sure that you are eating lean protein, making sure that you're having more healthier oils and fats and things of that nature.

[00:11:32] So having that combination will be helpful.

[00:11:34] So some diets that I find helpful for heart health is the Mediterranean diet.

[00:11:40] Also, plant-based diet is helpful.

[00:11:42] Even if you can't be totally plant-based, you can be plant-forward.

[00:11:45] So where you eat more meatless meals throughout the day, which can be helpful as well.

[00:11:51] And next is going to be the physical activity.

[00:11:53] So like I said, finding ways to exercise, finding ways to stay active is going to be important.

[00:12:00] And strength training will be important.

[00:12:02] That resistance training, as you start to tone that muscle, number one, like I said before, it burns more calories than fat does.

[00:12:09] So it helps with burning calories when you're not actually active.

[00:12:14] Also too, it helps with strengthening the bones.

[00:12:16] So making sure you have that toning can help with prevention of osteoporosis.

[00:12:21] And then of course, making sure you're adjusting your lifestyle.

[00:12:25] Are you getting enough rest?

[00:12:27] Are you managing your stress?

[00:12:29] Finding ways to have balance is always going to be important.

[00:12:33] Well, I thank you all so much for tuning in as we talk about perimenopause and weight gain.

[00:12:39] And how can we make this transition with grace?

[00:12:41] I look forward to seeing you all next week for our next week's podcast.

[00:12:47] And thank you again.

[00:12:48] And please feel free to leave us a comment on the Back on Track Achieving Healthy Weight Loss podcast.

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[00:12:58] And we look forward to seeing you next time.

[00:13:00] Have a great day.